State Health Insurance for Special Needs Child? (Cadiz, California: low income, income)

[slove1106]

Hi. I'd asked my friend from Kentucky about this since I was looking to move there and this is a very important matter in my family's lives (so I need to know prior to making a decision to move there) but she didn't know so I thought I'd ask here.

My 7 year old son has a medical problem called VATERS syndrome that requires extra special care. (Goes to doctors quite frequently, has had several surgeries, LOTS of insurance costs...) Here in California, I have him covered under 2 state medical insurances that covers all this. With the first, I pay a premium but it covers a lot more than what my insurance would cover. That one is Medi-Cal (a program for low-income, but also covers those who have extremely high bills due to disability or medical needs) and California Childrens Services, a program which covers children who go beyond Medi-Cal (surgeries and specialists, the more expensive stuff). I have insurance for myself and my daughter from my job, but I'm unable to cover him as my insurance although the best would not cover the tremendous amount of costs he incurrs due to his medical needs. His previous surgeries (six) alone would have cost over a million dollars.

Anyway, by moving I'd be losing not only those two insurances, but a large amount of doctors that have cared for him since he was born. Which is why I'm hoping to take care of most of his issues here prior to moving. He has one last surgery left which will hopefully be done in the next year.

A little background of my son. His medical issues aren't life threatening or anything (with correct care) but he requires constant monotoring by the doctors. When he was born, he was born with something called an imperforate anus, meaning his anal track wasn't developed all the way. From birth to about 3 years old, he had a colostomy which was then removed and now he's incontinent. He's forced to still wear diapers and we have him on bowel control programs. We're trying our best to have him live a normal life as a kid in spite of his medical problems.

On top of that, he also had something called a vesticostomy put in when he was 4 due to a neurogenic bladder. (Basically, his bladder is enlarged causing backtracking of urine to his kidneys thus giving him way too many kidney infections, thus the vesticostomy) He's a normal kid in any way except for the incontinency and the vesticostomy in which the docs will remove after his (hopefully) last surgery next year. Just by looking at him, you would never be able to tell he has any medical problems (except for the occassional "accident").

Don't worry, I'm getting to the question now. So by moving out of state, I need to be rest assured that other states have these types of medical programs for those with children who need more than average health care. In a few years, he won't really need as much care as his last surgery will have hopefully "fixed" the major problems and he'll be able to jump on my insurance. But as for now, personal health care won't be able to cover all his medical costs so I want to make sure that Kentucky has something like what we have here in California that covers exceptional health costs. My friend told me about something called KCHIP... Can anyone enlighten me on that? I'll be checking it out on the net today but any personal experiences with that program would be appreciated. Thank you!

Oh and one more thing. I don't mind any distance for this. But how are the specialists in the area of Cadiz? I'm sure with such a small town I'd be travelling quite a distance to get to any of these specialists. As for now, on top of his primary care physician, he has a neurologist, a urologist and a gastroenterologist (his surgeon) which he sees regularly. And they're about 25 miles away from me here so I wouldn't be surprised if I had to go much further there.

Thoughts? Suggestions? Thanks!

[tomocox]

I would not take anyone's word for such an important matter as you describe. I recommend that you contact: Kentucky.gov: - Children's Services & Programs (http://kentucky.gov/Portal/Category/hea_pediatric - broken link). You will want to speak with someone in the Cabinet for Human Resources that specializes in your needs. Get it in writing!!!!

[slove1106]

Thanks Tom. I'll actually be in KY on May 3rd and am planning to I guess answer some of my concerns about our move while we're there.

I did go to that link and see that you have many of the same services we have here in California. So in a way my question's is answered. (Just making sure you're one of the states that provides free/low cost health care for those who need it) Thanks.

[kygman]

I went to Kentucky.gov: - Home and put kchip in the search. Here's the first part:

KCHIP is only for uninsured children.
Eligibility requirements are based on age and family income. Children from birth through age 18 (until their 19th birthday) from low-income families are eligible. A family’s income can be up to and including 200% of Federal Poverty Level (FPL). For example, the income limit for a family of four would be $41,300 yearly or $3,442 monthly. Children must also be residents of Kentucky.



Children with existing health insurance may qualify for Medicaid but not for KCHIP. KCHIP is only for uninsured, low income children until the child's 19th birthday.
The following children have a six-month waiting period from the time they become uninsured until they can become eligible for KCHIP. Also, they are required to pay a premium:

• Infants - 186%-200% Federal Poverty Level (FPL)
• Age 1 through 18 years old - 151%-200% Federal Poverty Level (FPL)
• The six-month waiting period may be waived if the child loses health insurance for reasons that cannot be controlled. For more information, contact your local DCBS office.

The following children do not have a six-month waiting period from the time they become uninsured until they can become eligible for KCHIP. Also, they are not required to pay a premium.

• Age 1 through 5 years old - 134%-150% Federal Poverty Level (FPL)
• Age 6 through 18 years old - 101%-150% Federal Poverty Level (FPL)